GRILL FLAME SECURITY AGREEMENT

• Document Type: CREST
• Collection: STARGATE
• Document Number (FOIA) /ESDN (CREST): CIA-RDP96-00788R001200280026-2
• Release Decision: RIFPUB
• Original Classification: U
• Document Page Count: 2
• Document Creation Date: November 4, 2016
• Document Release Date: April 6, 2000
• Sequence Number: 26
• Publication Date: November 4, 1980
• Content Type: STATEMENT

Approved For Release 2000/08/07': CIA-RDP96-00788ROO1200280026-2
DATE'S
GRILL FLAME SECURITY AGREEMENT
I, L IL ~f ~//V`/,~(// understand that the highly
sensitive and classified information I have, or are about to
receive as part of the GRILL FLAME Program belongs to the
United States Government. I understand that the disclosure.
of this information is punishable under Title 18, Section
798, U.S.C., "Disclosure of Classified Information," June 1948,
as amended.
I do solemnly swear that I will never divulge, publish, or
reveal by word,. conduct, or by any other means such classified
information or knowledge, except in the performance of my
official-duties, and as specifically authorized in writing
in each case by the appropriate agency of the United States
Government.
I-understand that no change in my assignment or employment
will relieve-me of my obligation under this agreement and
that the provisions of this agreement will remain.-h.inding
upon me even after the termination of my services with the
United States Government.
I` take this obligation of my--own free will,:without- ,any mental.
reservation or purpose_of evasion.
DATA REQUIRED BY THE PRIVACY ACT OF 1974
(5 U..S.C... 552a)
1. Authority: National Records Act, 44 U.S.C. 3102;, E.O.
9397, Numbering System for Federal Accounts Relating to
individual Personsl, November 22, 1943.
2. Principal Purpose: To maintain a record of those individ-
uals who have or have had access to GRILL FLAME. information
through the use of their name and/or Social Security Number.
3. Routine Uses: The Social Security Number is to be used
to identify the individual, and the information is to be
retained strictly within the Program.
4. Mandatory or Voluntary Disclosure: Information is
disclosed on a voluntary basis, but withholding information
will render it impossible to grant an individual access to
or participation in the Program.
Approved For Release 2000/08/07 : CIA-RDP96-00788ROO1200280026-2
 Approved For Release 2000/08/07 : CIA-RDP96-00788R001200280026-2
GRILL FLAME SECURITY AGREEMENT CONTINUATION PAGE"
DATE (I kR 9e)
WITNESS
LJNIT7QRGANI IiTTON
SIGNED:
NAME, RAN It/GRADE
UNIT ORGANIZATION
POSITION
POSITION
2
Approved For Release 2000/08/07 CIA-RDP96-00788R001200280026-2